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330955
Utilizing a Community Health Worker model to reduce Diabetes burden in Chicago: The Lawndale Diabetes Project


Tuesday, November 3, 2015 : 8:50 a.m. - 9:10 a.m.

Dharani Ramanathan, MPH, Sinai Urban Health Institute, Chicago, IL
Michelle Hughes, PhD, Sinai Urban Health Institute, Chicago, IL
Dalia Majumdar, PhD, Sinai Urban Health Institute, Chicago, IL
Maureen Benjamins, PhD, Sinai Urban Health Institute, Chicago, IL
Audio (mp3) recording Recorded Presentation (mp4)
A Community Health Worker (CHW)-centered intervention was implemented to identify, support, and educate diabetics in two low-income Chicago communities. A unique door-to-door recruitment strategy was executed to engage individuals with limited access to healthcare and classify participants as diabetic, high risk, or low risk at baseline. Only diabetics were followed-up after one year. During home visits, CHWs provided education, counseling for diabetes self-management and referrals to free health resources. The aim was to lower the average HbA1c level in diabetics by ≥0.05%.

Of 2160 participants, 21% were diabetic, 24% were high risk, and 55% were low risk. The diabetic group (n=459) was 70% female; mean age was 56.3 years; 68% were African American and 30% were Hispanic. High blood pressure and being overweight were associated with increased odds of being diabetic or high risk compared to low risk participants. The average HbA1c decrease at follow-up was 0.5% (95% CI: 0.3% - 0.7%). Diabetics with high HbA1c levels at baseline (≥ 9.0%) showed a higher decrease of 1.7% (p<0.01) than all diabetics. Statistically significant increases were seen in diabetes-related knowledge and medication adherence, along with a decrease in proportion depressed at follow-up. 

This study adds to the growing literature demonstrating CHWs can effectively reach and serve participants outside a traditional healthcare system. Importantly, we showed that significant improvement in HbA1c is possible, even in underserved communities in Chicago. The approach could be extended to other chronic conditions to reduce health disparities in the US.

Learning Areas:

Chronic disease management and prevention

Learning Objectives:
Demonstrate whether a Community Health Worker intervention can help diabetics living in underserved communities List components of a Community Health Worker intervention that may be used for Diabetes management

Keyword(s): Community Health Workers and Promoters, Diabetes

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the program director for the Lawndale diabetes program at SUHI where this study was conducted. In this role, I am responsible for program design, evaluation, and dissemination of the diabetes program. In addition, I have over ten years of experience as a clinical dietitian and diabetes educator. In this role, I conducted several diabetes camps, counseled patients and their families, created educational resources, and organized several awareness campaigns.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4069.0: The Role of Community Health Workers in Diabetes Self-Management and Prevention (organized jointly with CHW section)